Does obesity impact lymph node retrieval in colon cancer surgery?

Am J Surg. 2010 Oct;200(4):478-82. doi: 10.1016/j.amjsurg.2009.12.012.

Abstract

Background: Evaluation of lymph nodes is important for the optimal treatment of colon adenocarcinoma. Few studies have assessed whether lymph node harvest is compromised by obesity. We hypothesized that lymph node retrieval in colon cancer resection would be reduced in obese patients.

Methods: Patients undergoing resection for colon adenocarcinoma diagnosed from 2000 to 2007 were reviewed retrospectively and stratified by body mass index (BMI). Lymph node harvest was evaluated.

Results: A total of 401 patients were included. Their mean age was 72.8 years, and 44% were men. Their mean BMI was 28.2 kg/m(2). Mean lymph node recovery among BMI groups was as follows: BMI less than 18.5 was 20.6; BMI of 18.5 to 24.9 was 25.1; BMI of 25 to 29.9 was 23.1; BMI of 30 to 34.9 was 22.4; BMI of 35 to 39.9 was 19.0; and BMI of 40 or greater was 21.1 nodes (P = .321). Surgical time increased with increasing BMI (P = .005). Adequacy of node harvest differed by stage (P = .007), left-sided versus right-sided resections (P = .001), and pathology technician (P = .001).

Conclusions: Lymph node retrieval was not affected by BMI.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / complications
  • Adenocarcinoma / secondary
  • Adenocarcinoma / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Colectomy / methods*
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery*
  • Female
  • Humans
  • Laparoscopy
  • Laparotomy
  • Lymph Node Excision / methods*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Obesity, Morbid / complications*
  • Obesity, Morbid / physiopathology
  • Risk Factors
  • Treatment Outcome
  • Weight Loss / physiology